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Innovative Perspective in Aging Care Open Access to Scientific and Medical Research DOI: 177286 Journal name: Clinical Interventions in Aging Article Designation: Perspectives Year: 2018 Volume: 13 Clinical Interventions in Aging Dovepress Running head verso: Gandarillas and Goswami Running head recto: Merging current health care trends: innovative perspective in aging care open access to scientific and medical research DOI: 177286 Open Access Full Text Article PERSPECTIVES Merging current health care trends: innovative perspective in aging care Miguel Ángel Gandarillas1 Abstract: Current trends in health care delivery and management such as predictive and Nandu Goswami2,3 personalized health care incorporating information and communication technologies, home- based care, health prevention and promotion through patients’ empowerment, care coordination, 1Department of Social Psychology and Methodology, Faculty of community health networks and governance represent exciting possibilities to dramatically Psychology, Autonomous University improve health care. However, as a whole, current health care trends involve a fragmented and of Madrid, Spain; 2Physiology Division, Otto Loewi Center of scattered array of practices and uncoordinated pilot projects. The present paper describes an Vascular Biology, Immunity and innovative and integrated model incorporating and “assembling” best practices and projects Inflammation, Medical University of of new innovations into an overarching health care system that can effectively address the Graz, Graz, Austria; 3Department of Health Science, Alma Mater Europea multidimensional health care challenges related to aging patient especially with chronic health University, Maribor, Slovenia issues. The main goal of the proposed model is to address the emerging health care challenges of an aging population and stimulate improved cost-efficiency, effectiveness, and patients’ well- For personal use only. being. The proposed home-based and community-centered Integrated Healthcare Management System may facilitate reaching the persons in their natural context, improving early detection, Video abstract and preventing illnesses. The system allows simplifying the health care institutional structures through interorganizational coordination, increasing inclusiveness and extensiveness of health care delivery. As a consequence of such coordination and integration, future merging efforts of current health care approaches may provide feasible solutions that result in improved cost- efficiency of health care services and simultaneously increase the quality of life, in particular, by switching the center of gravity of health delivery to a close relationship of individuals in their communities, making best use of their personal and social resources, especially effective in health delivery for aging persons with complex chronic illnesses. Keywords: health management, e-health, patient-centered health care, home-based care, health governance, community health Clinical Interventions in Aging downloaded from https://www.dovepress.com/ by 54.70.40.11 on 28-Dec-2018 Point your SmartPhone at the code above. If you have a Introduction QR code reader the video abstract will appear. Or use: In recent years, health care delivery has witnessed a vertiginous revolution. Informa- http://youtu.be/aTF0J65FLUE tion and communication technologies (ICT) are bringing a new reality, allowing for powerful means of processing a variety of data about many individuals in differ- ent environments. This is facilitating the development of fresh and more effective approaches to prevention and treatment not possible just a few years ago. This rapid development of ICT brings new advantages but new challenges as well. On the posi- Correspondence: Nandu Goswami tive side, ICT tools are allowing more autonomy and quality of life for patients and Physiology Division, Otto Loewi Center improving cost-efficiency of health centers, promoting a new culture of interagency col- of Vascular Biology, Immunity and laboration and public participation. This may especially benefit patients with complex, Inflammation, Medical University of Graz, Neue Stiftingtalstrasse 6, D-5, A-8010 multidimensional problems and comorbidities, as often occurs in many cases of older Graz, Austria people with chronic diseases (CD).1 On the negative side, home-based ICT may pose Tel +43 316 3857 3852 Email [email protected] new challenges for both the patient and the health care service. For the patient, such submit your manuscript | www.dovepress.com Clinical Interventions in Aging 2018:13 2083–2095 2083 Dovepress © 2018 Gandarillas and Goswami. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you http://dx.doi.org/10.2147/CIA.S177286 hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Powered by TCPDF (www.tcpdf.org) 1 / 1 Gandarillas and Goswami Dovepress challenges can include increased dependence on their health and many of these dependency-related problems thus increase center, false expectations of protection, difficulties managing the occurrence of possible comorbidities.16,17 This implies the technology, increased isolation, excessive feelings of higher need for dependency-related complex care. Unsur- responsibility and blame, and false alarms created by disease prisingly, CD are currently the main cause of dependency predictions. For the health care services, challenges can of the aging population in developed countries. The data on include difficulties in data protection, an overwhelming flow CD clearly points out the need to improve early detection of of data, and the need for new human resources, training, and CD and preventive care using multilevel approaches. organizational structures.2–8 New ICT will not be maximally effective by just adapting the traditional health care systems Current trends in health care innovation for the to incorporate such tools. Such an introduction of a new ICT aging CD patient may represent more problems than advantages. We need to Traditional illness-centered health care models fall short move forward toward novel health care approaches that are when facing the CD challenges in our increasing aging capable of making the best use of the potentials of new ICT population. As the World Health Organization already along with the development of current trends. Current trends, challenged the traditional view in its definition of health in approaches, and paradigms such as those pointed below are 1948, nowadays health care trends try to go further. Some implemented in a myriad of scattered practices that need to authors18 propose to define health as “the ability to adapt and be analyzed, incorporating the emerging tools and methods to self-manage”, reflecting the current reality of older chronic into solid systems. patients. Current trends try to make health services more The aim of the present work was to suggest feasible effective by being personalized and tailored to the patients’ ways of incorporating these practices into a general model needs, resources, and characteristics, based on early detection of advancement and innovation in health care delivery and of risks and preventive treatment in the person’s environment. management. New ICT tools for ambulatory care are strongly contributing to the feasibility of home-based health care even in serious For personal use only. Challenges and opportunities in current cases which just some years ago were restricted to intensive health care trends of chronic diseases care units in hospitals.19,20 But the application of these insights The rising prevalence of chronic diseases is hampered by the fragmentation of services in most health As people live longer, CD (such as chronic cardiovascular systems.21–23 The latest health care approaches are stressing diseases, arthritis, osteoporosis, diabetes, hypertension, neu- the need to advance new frameworks for collaboration among rodegenerative disorders, severe psychiatric illnesses, chronic social and health services in order to address the complex respiratory disorders, severe chronic pain problems, and nature of CD progression in the older person, including bio- dementia) are increasing in their relative prevalence when logical, physiological, psychological, social, and contextual compared with other types of illnesses and are currently factors (eg, de Bruin et al and Burns et al24,25). Current health the leading causes of deaths in many countries, especially care trends do recognize such challenges and are progressing Clinical Interventions in Aging downloaded from https://www.dovepress.com/ by 54.70.40.11 on 28-Dec-2018 striking the aging population (eg, 75% of the population may towards attaining the desired integration of health elements die from CD in developed countries in the near future9–12).11 and services. A bibliographic review of evaluative research The multidimensionality of CD in the elderly is of particular on innovative practices in the field allowed us to group them importance, with different aggravating factors appearing in the following current trends: together with general deterioration of physical and
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